AIM: To evaluate the clinical presentations and visual outcomes of non-arteritic anterior ischaemic optic neuropathy (NAION). METHODS: A retrospective study was conducted involving 18 consecutive patients (20 eyes) with NAION attending Hospital Universiti Sains Malaysia from January 2005 until December 2009. RESULTS: Most patients were Malay (94.4%), and followed by Chinese (5.6 %). The female-to-male ratio was 3.5:1. The age of patients ranged from 36 to 85 years (mean, 57.1 years). The main risk factors in systemic diseases were hypertension (55.5%), diabetes mellitus (44.4%), and ischaemic heart disease (11.1%). Most patients (77.8%) presented with acute loss of vision while gradual onset was in 22.3% of cases. Majority had visual acuity worse than 1/60 (80%). The most common fundoscopic findings were peripapillary splinter haemorrhage (90%), sectorial swollen optic disc (60%) and hyperemic disc (60%). During follow up, 20% of the patients showed stabilization in visual acuity, and 80% showed worsening of vision. CONCLUSION: Majority of patients with NAION presented with acute poor vision involving middle-aged and elderly individuals. Hypertension and diabetes mellitus were among the main risk factors involved. NAION can lead to permanent visual loss despite treatment.